Agriculture Reference
In-Depth Information
African surgery ever documented is the eyewitness account by a missionary doctor named Felkin
3
of a cesarean section performed by a Banyoro traditional surgeon in Uganda in 1879:
The patient was a healthy-looking primipara (first pregnancy) of about twenty years of age and she lay
on an inclined bed, the head of which rested against the side of the hut. She was half-intoxicated with
banana wine, was quite naked and was tied down to the bed by bands of bark cloth over the thorax and
thighs. Her ankles were held by a man ... while another man stood on her right steadying her abdomen
... the surgeon was standing on her left side holding the knife aloft and muttering an incantation. He
then washed his hands and the patient's abdomen first with banana wine and then water. The surgeon
made a quick cut upwards from just above the pubis to just below the umbilicus severing the whole
abdominal wall and uterus so that amniotic fluid escaped. Some bleeding points in the abdominal wall
were touched with red hot irons. The surgeon completed the uterine incision, the assistant helping by
holding up the sides of the abdominal wall with his hand and hooking two fingers into the uterus. The
child was removed, the cord cut, and the child was handed to an assistant.
Finch continued the story by stating that:
The surgeon squeezed the uterus until it contracted, dilated the cervix from inside with his fingers (to
allow post-partum blood to escape), removed clots and the placenta from the uterus, and then sparingly
used red hot irons to seal the bleeding points. A porous mat was tightly secured over the wound and the
patient turned over the edge of the bed to permit drainage of any remaining fluid. The peritoneum, the
abdominal wall, and the skin were approximated back together and secured with seven sharp spikes. A
root paste was applied over the wound and bandage of cloth was tightly wrapped around it. Within six
days, all the spikes were removed. Felkin observed the patient for 11 days and when he left, mother and
child were alive and well.
Among the “Usen” clan of Bini, it was considered an extreme manifestation of weakness on the
man's part for his wife to deliver a baby in the hospital. The husband of such a woman was disgraced
and humiliated for “not being man enough” to obtain the appropriate medicine to enable his wife to
deliver at home. The actual delivery process is like that of Western medicine, except that the prone
position is not common. The umbilical cord is cut only after the release of the placenta. It has been
suggested that this practice has an advantage for the newborn in that it allows it to avail itself of the
residual placental blood.
1
The cut is performed with any sharp object (sticks, bamboo, etc.); more
recently, razor blades and scissors have come into frequent use. The cord is knotted soon after cut-
ting. Medication is applied immediately. The method and ingredients depend on the locality; ashes,
cassava flower, cow dung, palm oil, and vegetable packs are among the common ones. The released
placenta is buried in the ground; sometimes, the detached umbilical cord is worn by the baby as an
amulet. This is easy to understand since the problem associated with the healing of the cord is not at
all easy for a society that is not blessed with knowledge of modem antibiotics. Some tribes bury it and
plant a palm tree (
nkwu alulo
in Igbo) or a banana tree above it. The plant is, as it were, dedicated to
the newborn; the first fruit is cherished and is usually reserved for the family elder.
African mothers abhor feeding their babies with animal milk; there is pride in breast-feeding
a baby, and children usually are breast-fed openly. Infants are breast-fed for about 2 years unless
interrupted by a new pregnancy. Sex is usually not allowed while nursing.
the Surgeon
Evidence is available to show that some African surgeons attained a level of skill that is compa-
rable, and in some respects superior, to that of Western surgeons, at least up to the twentieth century.
Traumatic wounds were easily treated, and a red hot metal tip was used to cauterize bleeding points.
There is a documented story of a traditional surgeon who successfully resected part of a patient's
